Análise de estratégia para aplicação de sistema eletrônico na referência e contrarreferência nos serviços de saúde

• Autor(a) principal: Morato, Márcia Gasparini Canuto
• Data de Publicação: 2013
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/3540
• topic: Atenção primária à saúde; Referência e contrarreferência; Tecnologia em saúde; Primary health care; Reference and counter reference; Technology in health; CIENCIAS DA SAUDE::SAUDE COLETIVA

Introduction: In recent times, the Brazilian Unified Health System has undergone several innovations in management, organizing, financing and services. In this context, looms as a major strengthening of the system of Primary Health Care, which has demonstrated the essence of the effectiveness of care, enabling a holistic approach to people. In this sense, it is necessary an efficient monitoring of the patient by means of the reference and counter reference. Objective: To analyze strategies to implement the Electronic System Reference and counter reference in the Family Health Unit (FHU) in the city of Anápolis, Goiás. Material and Methods: The study was a prospective, nonrandomized intervention, developed in two of the three FHU research. The experimental and control groups were chosen on the basis of convenience. Visits were made by the researcher to the health units, explanations about the research and requests for assistance to the professionals. The interventions were performed by means of encouragement and guidance to professionals and patients. It was used among the instruments: Sheets Guidelines and Flow and Letter Search. In one of FHU Intervention was made available the Electronic Reference and counter reference. We carried out the monitoring, the FHU study and the National Regulatory System (SISREG), the flow of patients referred to specialists in the period from 1 August 2012 to 1 December 2012. Visits to medical specialists were made who treated the patients referred and also active search for patients who have not returned or returned without the counter reference - FHU source. It was evaluated the number of references, counter reference and reasons for non-return of patients and counter reference to the three FHU from study. Data were analyzed using STATA version 11.0. Results: Of the total of 6,218 medical consultations, it was performed 532 accompaniments to specialists physicians and 492 patients accompaniments. The referral rate was 8.56 %. They were requested and scheduled more appointments in FHU intervention. Of referrals made, 54.27 % were scheduled consultations. Of these, 11.61 % patients returned to FHU source routing. The time of the patient's return home to FHU, after issuing the referral reference ranged from 6 to 110 days. The patients return home at FHU occurred only in Intervention, and of these patients, almost half returned to the counter reference manually. Conclusions: The study demonstrated rate of referrals in accordance with international standards; difficulties of access to specialized consultations, low number of patients returns to FHU source routing, as well , that guidance and encouragement to professionals and patients positively affect the patients return to the FHU and counter reference source. It was believed to be feasible to implement the referral system and counter reference electronically, allowing better communication between professionals safely and quickly and greater integration between services.